Axillary artery aneurysm is the rarest peripheral artery aneurysm. Most of them are asymptomatic [
1]. The natural history of axillary artery aneurysms is not well known due to the limited number of cases. However, with the advent of more sophisticated imaging modalities, these aneurysms are now less likely to be missed. Aneurysms of the axillary artery are generally secondary to blunt or penetrating trauma, causing arterial degeneration. This includes the use of axillary crutches or high-stress overhead arm motions during athletic activities [
2]. Infectious and degenerative causes are unusual, but have been reported [
3,
4]. Atherosclerosis, collagen vascular disease, advanced age, mycotic aneurysm and thoracic outlet syndrome have also been described as etiologies [
5,
6]. The recognition and treatment of these aneurysms are important because they tend to increase in size with an increased risk of rupture, thrombosis, embolization and compression of adjacent structures. No reports have documented any correlation between the absolute size of aneurysms and the potential risk for rupture, but if left untreated, rupture with life-threatening blood loss, thromboembolism leading to ischemia and limb loss, or irreversible neurological damage may occur. For this reason, prompt diagnosis and intervention is mandatory for axillary aneurysms even when they are asymptomatic. To date, the standard treatment for peripheral aneurysms is still surgical resection with end-to-end anastomosis, if necessary with autologous or artificial patch repair [
1,
6]. Complications, such as thrombosis, embolism, rupture and rapid growth with increasing symptoms, are absolute indications of surgery. However, aneurysmectomy and interposition grafting with autologous or artificial vessels are more invasive. In addition, brachial or axillary veins may tend to develop aneurysms, and saphenous vein size matching may be difficult [
1,
5,
6]. The ideal treatment for axillary artery aneurysm should be relatively noninvasive, safe and free of significant complications, cost-effective, cosmetically acceptable, and incur less absence from usual daily activities. Endovascular stent grafts have also been successfully used to treat these aneurysms [
7]. They are a good alternative when the quality of the saphenous vein is inadequate or lacking. Most can be treated effectively with surgical excision and vascular grafting. The management of select aneurysms using stent grafts has become more prevalent with the developing endoluminal technology [
8‐
11]. It can be an effective and less invasive alternative to the standard surgical reconstruction, but only a few cases have been described in the literature with respect to axillary artery aneurysms. There has been only one case report that is similar to ours [
7]. In our case, an 8cm stent was placed successfully. There were no adverse peri-operative events including any ischemic symptoms of the left arm. A CT angiogram showed complete exclusion of the aneurysm without any endoleaks. The postoperative course of the patient was uneventful and the patient was discharged on the fifth postoperative day. On follow-up, the patient was symptom-free and no further studies were needed. We have shown that there are significant early advantages with this technique versus the conventional operation in the management of axillary artery aneurysm. We think that endovascular management of spontaneous axillary artery aneurysm is better than conventional surgical reconstruction. Although stenting across a mobile joint, such as the shoulder, can lead to problems like deformation and fractures of the stent, with the advent of stent grafts with increased flexibility, less compressibility and deformability, the role of endovascular treatment of peripheral aneurysms is promising. We recommend using this technique to deal with axillary artery aneurysm rather than the conventional operation.